Dr. George on Radium-223 in Combinations for mCRPC

Daniel J. George, MD, the director of GU Oncology at the Duke Cancer Institute, discusses the potential to incorporate radium-223 (Xofigo) into combination strategies as a treatment for patients with metastatic castration-resistant prostate cancer (mCRPC).

In general, George notes, radium-223 is a fantastic drug for combinations because of its favorable toxicity profile. Additionally, he notes, the agent is not being delivered at its maximum tolerated dose, which adds to its potential in combinations.

Many of the toxicities associated with radium-223 are gastrointestinal-related and do not overlap with those seen with other treatments, such as abiraterone acetate or enzalutamide, George notes. However, for chemotherapies, such as docetaxel, sequencing may be more effective than combinations, unless there's a large soft tissue component with symptomatic bone metastases, George believes.